DESCRIPTION (Applicant's abstract): This interdisciplinary project will use multiple research methods in two subprojects to explore: (A) The role of spirituality in adjustment of older and middle aged patients following cardiac surgery: The effectiveness of religiousness has been associated with placebo effect, hope, optimism and sense of control with a few empirical investigations. The present study attempts to make conceptual distinctions by evaluating constructs simultaneously. Specifically, we seek to advance knowledge of multifactorial determinants of adjustment and to test the hypothesis that spiritual experience will predict better adjustment. (B) Thee effects of Qigong in physical rehabilitation during hospitalization: Most research related to Qigong has been done in China with a focus on the clinical effect of internal Qigong practice. Fe have been done with a sound research design or with investigation of potential mechanisms. The proposed randomized controlled trial will explore the clinical efficacy of External Qigong therapy in cardiac surgical recovery. We hypothesize that Qigong will benefit patient's hospital recovery and through laboratory and clinical variables. These mechanisms will involve using standardized measurements of pain control and wound healing. Methods: The A and B will use the same patient sample (1) for A: Data from 400 patients (aged 40 and above) at the University of Michigan Medical Center will be gathered through a three wave, face-to-face interview and one telephone interview before and after the surgery. Standardized instruments will be employed. A hospital computerized database will provide other information. (2) For B: About 360 patients from the above sample will be randomly assigned to three groups: Qigong, placebo, and non-treatment. Four treatments will be provided for the first two groups following the surgery. Several laboratory tests will be conducted during hospitalization. Measures of pain control and wound healing will be conducted by the surgery. (3) For Both A and B: ANOVA, regression analyses, and structural equation modeling will be utilized for assessing major research questions and testing the primary hypothesis. The proposed research will enhance our understanding of possible mechanisms concerning the spiritual dimension in cardiac rehabilitation and promote the application of complementary medicine through sophisticated methodological and data-analytic strategies. Ultimately, the study will provide empirical tests for Wayne Jonas' theory on contributory cause model.